预防皮肤癌的行为咨询:美国预防服务工作组的证据报告和系统审查
Nora B Henrikson1, Caitlin C Morrison1, Paula R Blasi1
1Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Research Affiliates Evidence-based Practice Center, Seattle.
行为咨询可以改善防晒习惯和皮肤自我检查,但减少晒伤或皮肤癌症的证据有限. 一些干预措施可能会增加皮肤手术,但没有显著的癌症检测.
科学领域:
- 皮肤病学
- 公共卫生
- 预防医学
背景情况:
- 紫外线辐射,尤其是在儿童时期,是皮肤癌的重要危险因素.
- 行为辅导干预旨在通过改善防晒和自我检查行为来减轻这种风险.
研究的目的:
- 系统地审查皮肤癌预防行为咨询的益处和危害的证据.
- 为美国预防服务工作组 (USPSTF) 的建议提供信息.
主要方法:
- 在多个数据库 (Cochrane,MEDLINE,PubMed) 搜索了2009-2016年和2005-2016年的研究,并通过2018年进行监测.
- 包括公平和优质的初级保健相关的行为干预研究.
- 由于异质性,从21项试验 (N=20,561) 的数据进行了定性总结.
主要成果:
- 没有研究评估了儿童群体的皮肤癌结局. 一个成年人试验显示黑色素瘤诊断没有差异.
- 没有观察到儿童或成年人阳光烧伤频率的持续降低.
- 干预表明成年人防晒行为和皮肤自我检查的增加很小,而且可能增加皮肤手术.
结论:
- 行为干预有效地增加了防晒和皮肤自我检查行为.
- 这些干预措施与减少晒伤或皮肤癌症的结果缺乏一致的证据.
- 成年人的皮肤自我检查可能会加快皮肤手术,但不会改善癌症的检测.
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